Still a citizen? Experiences from people living with early-stage dementia in remote areas

Authors

DOI:

https://doi.org/10.7557/14.7456

Keywords:

person with dementia, dementia early-stage, social actor, inclusion, citizen, rural areas

Abstract

Our study shows how people with dementia in rural areas are experiencing various factors which affect their ability to engage in relationships and participate in society. The interviews with eight informants were summarized in five main themes pointing at different areas of importance for the informants' independence and control of life. These are: Factors which affect the ability to be mobile and travel independently (1), the ability to manage one's own financial matters (2), the ability to participate in informal arenas (3), the ability to participate in the working and social life (4), and factors that can promote independence and participation in general (5). Our findings show that various digital factors may limit participation: Among other things, informants experience that a complicated login to online banking may prevent the disposal of the informants' own money. Also, complicated graphical interfaces in social media may make it difficult to communicate with friends and family. Such difficulties may contribute to a deterioration of the condition of such individuals, with more exclusion as the result. Based on this study, we argue that the proper digital accommodation and facilitation are important measures to improve access to digital social arenas, with the ultimate goal to reduce digital exclusion.

Metrics

Metrics Loading ...

Author Biographies

Aud Berit Fossøy, Western Norway University of Applied Sciences

Accosiate professor

Till Halbach, Norwegian Computing Center

Senior Researcher

Siri Ytrehus, Western Norway University of Applied Sciences

Professor

References

Au, A., Lai, D. W., Yip, H.-m., Chan, S., Lai, S., Chaudhury, H., Scharlach, A., & Leeson, G. (2020). Sense of community mediating between age-friendly characteristics and life satisfaction of community-dwelling older adults. Frontiers in Psychology, 11, 86.

Bartlett, R. (2014). The emergent modes of dementia activism. Ageing & Society, 34(4), 623-644.

Bartlett, R., & O'Connor, D. (2007). From personhood to citizenship: Broadening the lens for dementia practice and research. Journal of Aging Studies, 21(2), 107-118. https://doi.org/10.1016/j.jaging.2006.09.002

Bartlett, R., & O'Connor, D. (2010). Broadening the dementia debate: Towards social citizenship. Policy press. https://doi.org/10.56687/9781847428585

Bosco, A., Schneider, J., Coleston-Shields, D. M., Jawahar, K., Higgs, P., & Orrell, M. (2019). Agency in dementia care: systematic review and meta-ethnography. International psychogeriatrics, 31(5), 627-642.

Bressan, V., Visintini, C., & Palese, A. (2020). What do family caregivers of people with dementia need? A mixed‐method systematic review. Health & social care in the community, 28(6), 1942-1960.

Calkins, M. P. (2018). From research to application: Supportive and therapeutic environments for people living with dementia. The Gerontologist, 58(suppl_1), S114-S128.

Demensplan. (2025). Demensplan 2025. https://www.regjeringen.no/no/dokumenter/demensplan-2025/id2788070/

Drageset, I. (2019). Research involving older persons with dementia; ethical considerations. Klinisk Sygepleje, 33(03), 219-233. https://doi.org/10.18261/issn.1903-2285-2019-03-05

Eriksen, S., Helvik, A.-S., Juvet, L. K., Skovdahl, K., Førsund, L. H., & Grov, E. K. (2016). The experience of relations in persons with dementia: a systematic meta-synthesis. Dementia and geriatric cognitive disorders, 42(5-6), 342-368. https://doi.org/10.1159/000452404

Fossøy, A. B., Grov, E. K., & Sandvoll, A. M. (2018). Magiske augneblikk; erfaringar med kulturprosjekt for eldre. Tidsskrift for omsorgsforskning, 4(2), 132-142. https://doi.org/10.18261/issn.2387-5984-2018-02-09

Førsund, L. H., Grov, E. K., Helvik, A.-S., Juvet, L. K., Skovdahl, K., & Eriksen, S. (2018). The experience of lived space in persons with dementia: a systematic meta-synthesis. BMC geriatrics, 18(1), 33. https://doi.org/10.1186/s12877-018-0728-0

Graham, H., De Bell, S., Flemming, K., Sowden, A., White, P., & Wright, K. (2020). Older people's experiences of everyday travel in the urban environment: a thematic synthesis of qualitative studies in the United Kingdom. Ageing & Society, 40(4), 842-868.

Halbach, T., & Tunold, S. (2020). Teknologiens mange sider i synshemmedes arbeidsliv. Report at the Norwegian Computing Center.

Harris, P. B. (2013). Dementia and friendship: the quality and nature of the relationships that remain. The International Journal of Aging and Human Development, 76(2), 141-164. https://doi.org/10.2190/AG.76.2.c

Haugen, I., Slettebø, T., & Ytrehus, S. (2019). Factors affecting user participation for elderly people with dementia living at home: a critical interpretive synthesis of the literature. European Journal of Social Work, 22(6), 974-986.

Heaton, J., Martyr, A., Nelis, S. M., Marková, I. S., Morris, R. G., Roth, I., Woods, R. T., & Clare, L. (2021). Future outlook of people living alone with early-stage dementia and their non-resident relatives and friends who support them. Ageing & Society, 41(11), 2660-2680.

Hebert, C. A., & Scales, K. (2019). Dementia friendly initiatives: A state of the science review. Dementia, 18(5), 1858-1895. https://doi.org/10.1177/1471301217731433

Hellström, I., Nolan, M., & Lundh, U. (2005). ‘We do things together’ A case study of ‘couplehood’in dementia. Dementia, 4(1), 7-22.

Holden, A., & Pusey, H. (2021). The impact of driving cessation for people with dementia–An integrative review. Dementia, 20(3), 1105-1123.

Hughes, B. (2009). Disability activisms: Social model stalwarts and biological citizens. Disability & Society, 24(6), 677-688. https://doi.org/10.1080/09687590903160118

Hughes, J. C. (2011). Thinking through dementia. Oxford University Press. https://books.google.no/books?hl=no&lr=&id=VK9G8hBDev8C&oi=fnd&pg=PR15&dq=hughes+2011+thinking+through&ots=5dmNYlybzu&sig=DmbNRmCPE5rYTywwiS15bDNDeRs&redir_esc=y#v=onepage&q=hughes%202011%20thinking%20through&f=false

Hung, L., Hudson, A., Gregorio, M., Jackson, L., Mann, J., Horne, N., Berndt, A., Wallsworth, C., Wong, L., & Phinney, A. (2021). Creating dementia-friendly communities for social inclusion: a scoping review. Gerontology and Geriatric Medicine, 7, 23337214211013596. https://doi.org/10.1177/23337214211013596

Kelly, F., & Innes, A. (2013). Human rights, citizenship and dementia care nursing. International journal of older people nursing, 8(1), 61-70.

Lee, K., Chung, J., Meyer, K. N., & Dionne-Odom, J. N. (2022). Unmet needs and health-related quality of life of dementia family caregivers transitioning from home to long-term care: A scoping review. Geriatric Nursing, 43, 254-264.

Lin, S.-Y. (2017). ‘Dementia-friendly communities’ and being dementia friendly in healthcare settings. Current opinion in psychiatry, 30(2), 145.

Lister, R. (2007). Inclusive citizenship: Realizing the potential. Citizenship studies, 11(1), 49-61. https://doi.org/10.1080/13621020601099856

Malterud, K. (2017a). Kvalitativ metasyntese som forskningsmetode i medisin og helsefag. Universitetsforl.

Malterud, K. (2017b). Kvalitative forskningsmetoder for medisin og helsefag (4. utg. ed.). Universitetsforl.

Martin, C., Shrestha, A., Burton, M., Collins, K., & Wyld, L. (2019). How are caregivers involved in treatment decision making for older people with dementia and a new diagnosis of cancer? Psycho‐Oncology, 28(6), 1197-1206.

Motta-Ochoa, R., Leibing, A., Bresba, P., Williams, M., Shaffer, S., Julien, O., Racine, E., & Blain-Moraes, S. (2021). “You’re part of us and we’re happy to have you here”: Practices of social inclusion for persons with dementia. Clinical Gerontologist, 44(4), 470-481.

NOU 2020:15. Det handler om Norge. Bærekraft i hele landet. Utredning om konsekvenser av demografiutfordringer i distriktene. https://www.regjeringen.no/no/dokumenter/nou-2020-15/id2788079/

Novek, S., & Wilkinson, H. (2019). Safe and inclusive research practices for qualitative research involving people with dementia: A review of key issues and strategies. Dementia, 18(3), 1042-1059. https://doi.org/10.1177/1471301217701274

Odzakovic, E., Kullberg, A., Hellström, I., Clark, A., Campbell, S., Manji, K., Rummery, K., Keady, J., & Ward, R. (2021). ‘It's our pleasure, we count cars here’: an exploration of the ‘neighbourhood-based connections’ for people living alone with dementia. Ageing & Society, 41(3), 645-670.

Paulovich, B., Pedell, S., Tandori, E., & Beh, J. (2022). Weaving Social Connectivity into the Community Fabric: Exploring Older Adult’s Relationships to Technology and Place. International Journal of Environmental Research and Public Health, 19(14), 8500.

Pinkert, C., Köhler, K., von Kutzleben, M., Hochgräber, I., Cavazzini, C., Völz, S., Palm, R., & Holle, B. (2021). Social inclusion of people with dementia–an integrative review of theoretical frameworks, methods and findings in empirical studies. Ageing & Society, 41(4), 773-793. https://doi.org/10.1017/S0144686X19001338

Pinto-Bruno, Á. C., García-Casal, J. A., Csipke, E., Jenaro-Río, C., & Franco-Martín, M. (2017). ICT-based applications to improve social health and social participation in older adults with dementia. A systematic literature review. Aging & Mental Health, 21(1), 58-65. https://doi.org/10.1080/13607863.2016.1262818

Rai, H. K., Kernaghan, D., Schoonmade, L., Egan, K. J., & Pot, A. M. (2022). Digital Technologies to Prevent Social Isolation and Loneliness in Dementia: A Systematic Review. Journal of Alzheimer's disease, 90, 513-528. https://doi.org/10.3233/JAD-220438

Rapaport, P., Burton, A., Leverton, M., Herat-Gunaratne, R., Beresford-Dent, J., Lord, K., Downs, M., Boex, S., Horsley, R., & Giebel, C. (2020). “I just keep thinking that I don’t want to rely on people.” a qualitative study of how people living with dementia achieve and maintain independence at home: stakeholder perspectives. BMC geriatrics, 20, 1-11.

Riikonen, M., Paavilainen, E., & Salo, H. (2013). Factors supporting the use of technology in daily life of home-living people with dementia. Technology and Disability, 25(4), 233-243.

Rodriguez, F. S., Pabst, A., Heser, K., Kleineidam, L., Hajek, A., Eisele, M., Röhr, S., Löbner, M., Wiese, B., Angermeyer, M. C., Maier, W., Scherer, M., Wagner, M., König, H.-H., & Riedel-Heller, S. G. (2021). Disorientation in Time and Place in Old Age: Longitudinal Evidence from Three Old Age Cohorts in Germany (AgeDifferent.de Platform). Journal of Alzheimer’s Disease, 79(4), 1589-1599. https://doi.org/10.3233/JAD-201008

Rostad, D., Hellzén, O., & Enmarker, I. (2013). The meaning of being young with dementia and living at home. Nursing Reports, 3(1), e3-e3. https://doi.org/10.4081/nursrep.2013.e3

Satariano, W. A., Guralnik, J. M., Jackson, R. J., Marottoli, R. A., Phelan, E. A., & Prohaska, T. R. (2012). Mobility and aging: new directions for public health action. American journal of public health, 102(8), 1508-1515.

Schwanen, T., Banister, D., & Bowling, A. (2012). Independence and mobility in later life. Geoforum, 43(6), 1313-1322. https://doi.org/10.1016/j.geoforum.2012.04.001

Shannon, K., Bail, K., & Neville, S. (2019). Dementia‐friendly community initiatives: An integrative review. Journal of Clinical Nursing, 28(11-12), 2035-2045. https://doi.org/10.1111/jocn.14746

Smebye, K. L., Kirkevold, M., & Engedal, K. (2015). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study. Bmc Health Services Research, 16(1), 1-12.

Talbot, C. V., Roe, D., & Brunner, M. (2024). Navigating who I was and who I am online: How people with dementia use social media platforms to support identity. Dementia, 14713012241292659. https://doi.org/10.1177/14713012241292659

Thagaard, T. (2018). Systematikk og innlevelse : en innføring i kvalitative metoder (5. utg. ed.). Fagbokforl.

Wessel, T., & Barstad, A. (2016). Urbanisering og urbanisme. In L. Kjølsrød & I. Frønes (Eds.), Det norske samfunn (pp. s. 61-86).

World Health Organization. (2021). Towards a dementia-inclusive society: WHO toolkit for dementia-friendly initiatives (DFIs) (9240031537). https://apps.who.int/iris/bitstream/handle/10665/343780/9789240031531-eng.pdf?sequence=1

Downloads

Published

2025-05-06

How to Cite

Fossøy, A. B., Halbach, T. ., & Ytrehus, S. . (2025). Still a citizen? Experiences from people living with early-stage dementia in remote areas. Nordisk Tidsskrift for Helseforskning, 21(1). https://doi.org/10.7557/14.7456

Issue

Section

Refereebedømte artikler

Most read articles by the same author(s)